为腹疾病寻求护理:系统性审查和元分析
Kirsten E Wiens1, Marissa H Miller1, Daniel J Costello1,2
1Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, USA.
medRxiv : the preprint server for health sciences
|December 23, 2024
概括
寻求腹护理的人往往被低估,因为许多人不会在医院或诊所寻求护理. 未来的研究应该包括所有年龄组,并探索医疗保健设施以外的各种护理来源.
科学领域:
- 全球健康 全球健康
- 流行病学 流行病学
- 公共卫生监督 公共卫生监督
背景情况:
- 腹疾病的监测通常依赖于医院/诊所的访问,不包括从药房和社区卫生工作者 (CHW) 寻求的护理.
- 现有的疾病负担估计可能是不准确的,因为低估了非设施医疗寻求.
- 关于腹寻求护理行为的研究通常集中在五岁以下的儿童身上,忽视了其他受霍乱等疾病影响的年龄组.
研究的目的:
- 估计不同年龄组,病例定义和研究环境中寻求腹护理的个体比例.
- 通过检查报告不足的寻求护理行为来确定当前疾病负担估计中的差距.
- 通过更全面地了解寻求护理模式,为减轻腹的资源分配提供信息.
主要方法:
- 在62个国家从2000年至2024年对166项基于人口的初级研究进行了系统审查.
- 利用随机效应的元分析来合成关于腹寻求护理行为的数据.
- 根据年龄组,病例定义 (一般腹,严重腹,霍乱) 和研究环境分析了寻求护理的模式.
主要成果:
- 医院和诊所是最常见的护理来源,社区卫生工作者 (CHW) 和卫生站很少被记录.
- 平均32.8%的腹病例在医院或诊所寻求治疗,在低收入和中等收入国家有很大的异质性 (I2 = 99.3).
- 与一般性腹相比,严重腹和霍乱病例在寻求医院/诊所护理的几率显著更高 (OR 3.43),尽管与年龄相关的护理寻求差异在统计学上并不显著.
结论:
- 通过医院和诊所的被动监测可能低估了腹的真正负担,特别是对较轻的病例.
- 未来的研究必须涵盖所有年龄组的护理寻求,并调查代表性不足的来源,如卫生站和CHW.
- 调查结果强调需要采用包容性数据收集方法,以准确评估腹疾病负担并指导公共卫生干预.
相关概念视频
01:18Drugs Affecting GI Tract Motility: Antimicrobials as Antidiarrheal Agents
107
Acute diarrhea, a common gastrointestinal disturbance, is characterized by the rapid evacuation of fluid stools, leading to an excessive weight in fluid. This condition typically arises from disorders affecting intestinal water and electrolyte transport. It can be triggered by an increased osmotic load within the intestine, excessive secretion of electrolytes and water, mucosal exudation of protein and fluid, or altered intestinal motility. The primary risks of acute diarrhea are dehydration...
107
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
315
Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
315
01:17Drugs for Treatment of Diarrhea-Predominant IBS
147
Diarrhea-predominant irritable bowel syndrome (IBS-D) is a subtype of IBS characterized primarily by frequent, loose, or watery stools, abdominal pain, and abdominal discomfort. Therapeutic approaches to managing IBS-D include dietary changes, stress management techniques, and pharmaceutical interventions.
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
147
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
135
Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
135
01:17Chronic Bowel Disorders: Introduction
386
Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
386
01:17Assessment of the Gastrointestinal System I: Subjective Data
144
Assessing the gastrointestinal (GI) system is a complex process that begins with collecting subjective data. This data, collected through patient interviews, provides crucial insights into the patient's health history, perception patterns, and lifestyle habits, all contributing significantly to GI health.
Health History
The initial step in assessing the GI system is obtaining a comprehensive health history. This includes inquiring about the patient's history or presence of problems...
Health History
The initial step in assessing the GI system is obtaining a comprehensive health history. This includes inquiring about the patient's history or presence of problems...
144